Abstract

Sex differences in the prevalence, incidence, and severity of osteoarthritis (OA)
have long been known. Some differences in the evaluation of this issue across studies
may be related to differences in study design, sampling, study size, study populations,
targeted joint sites, and definitions of OA. This report highlights recent studies
of sex differences in individual joint components imaged by magnetic resonance imaging
and in systemic biomarkers of joint metabolism. Particularly important are those studies
that examine this issue in young unaffected adults and children before the development
of disease. Despite some variation across studies, women appear for the most part
to have a thinner and more reduced volume of cartilage in the knee than men, and this
may occur from early childhood. It is not clear whether women have a more accelerated
rate of cartilage volume loss than men. Few data exist on sex differences in systemic
biomarkers of joint metabolism. In these studies, it is critically important to characterize
the total body burden of OA and the presence of comorbid conditions likely to influence
a given biomarker. Lastly, future research should dovetail studies of sex differences
in imaging and biochemical biomarkers with genetics to maximize insight into the mechanisms
behind observed sex differences.